Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $81.28 / $158.49	Facility		$39.81	$81.28	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $40.74 / $50.12	Professional		$39.81	$40.74	$50.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $100.00 / $186.21	Facility		$39.81	$100.00	$186.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
Christus Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $79.43	Facility		$39.81	$39.81	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $39.81 / $39.81	Facility		$38.02	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $870.96	Facility		$812.83	$812.83	$870.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,445.44	Professional		$1,071.52	$1,071.52	$1,445.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $46.77 / $323.59	Facility		$39.81	$46.77	$323.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $43.65	Professional		$39.81	$39.81	$43.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $53.70	Professional		$37.15	$44.67	$53.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $83.18 / $199.53	Professional		$30.20	$83.18	$199.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $50.12 / $363.08	Facility		$39.81	$50.12	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $56.23	Professional		$39.81	$39.81	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $42.66 / $44.67	Professional		$39.81	$42.66	$44.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $50.12	Professional		$39.81	$39.81	$50.12